Systematic Review on Chemsex: Advocating for Inclusive Research and Primary Prevention

Area of Science:

• Public Health
• Sexual Health
• Addiction Research

Background:

• Chemsex, a form of sexualized drug use (SDU), is primarily associated with men who have sex with men (MSM), posing significant public health challenges like increased sexually transmitted infections and HIV.
• Existing research on chemsex often overlooks diverse sexual orientations and gender identities, necessitating a broader scope to understand the phenomenon comprehensively.

Approach:

• A systematic review adhering to PRISMA guidelines was conducted across major databases (Cochrane Library, PubMed/MEDLINE, Scopus, Web of Science) from April to July 2024.
• Studies were synthesized narratively, with methodological quality assessed using the Mixed Methods Appraisal Tool (MMAT).
• Two distinct searches focused on (1) chemsex prevalence across diverse populations and (2) characteristics and effectiveness of non-prophylactic interventions.

Key Points:

• The review identified 14 relevant studies on chemsex and SDU, analyzing their presence in diverse samples regarding sexual orientation and gender identity.
• No primary or secondary prevention interventions for chemsex were identified; however, risk reduction interventions demonstrated efficacy in decreasing chemsex practices, unsafe sexual behaviors, and substance use.
• Chemsex involves complex dynamics within sexually minoritized groups, influenced by gender, sexual orientation, and social insecurities.

Conclusions:

• There is a critical gap in primary prevention interventions for chemsex, despite the documented effectiveness of risk reduction strategies.
• Further research is essential to include a wider range of populations affected by chemsex.
• Developing inclusive and targeted strategies is crucial for addressing the multifaceted nature of chemsex within diverse communities.